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Hanlon P, Wightman H, Politis M, Kirkpatrick S, Jones C, Andrew MK, Vetrano DL, Dent E, Hoogendijk EO. The relationship between frailty and social vulnerability: a systematic review. THE LANCET. HEALTHY LONGEVITY 2024; 5:e214-e226. [PMID: 38432249 DOI: 10.1016/s2666-7568(23)00263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/05/2024] Open
Abstract
Both frailty (reduced physiological reserve) and social vulnerability (scarcity of adequate social connections, support, or interaction) become more common as people age and are associated with adverse consequences. Analyses of the relationships between these constructs can be limited by the wide range of measures used to assess them. In this systematic review, we synthesised 130 observational studies assessing the association between frailty and social vulnerability, the bidirectional longitudinal relationships between constructs, and their joint associations with adverse health outcomes. Frailty, across assessment type, was associated with increased loneliness and social isolation, perceived inadequacy of social support, and reduced social participation. Each of these social vulnerability components was also associated with more rapid progression of frailty and lower odds of improvement compared with the absence of that social vulnerability component (eg, more rapid frailty progression in people with social isolation vs those who were not socially isolated). Combinations of frailty and social vulnerability were associated with increased mortality, decline in physical function, and cognitive impairment. Clinical and public health measures targeting frailty or social vulnerability should, therefore, account for both frailty and social vulnerability.
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Affiliation(s)
- Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Heather Wightman
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Marina Politis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Caitlin Jones
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Melissa K Andrew
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontological Research Center, Stockholm, Sweden
| | - Elsa Dent
- Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, Netherlands
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Nazari S, Bakhtiyary M, Shabestari A, Sharifi F, Afshar P. Relationship between Lifestyle and Frailty among Iranian Community-Dwelling Older Adults: Pilot Study. JAR LIFE 2023; 12:93-99. [PMID: 38046197 PMCID: PMC10690137 DOI: 10.14283/jarlife.2023.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/03/2023] [Indexed: 12/05/2023]
Abstract
Background Aging affects physical, mental, and social functions, which can lead to an increase in frailty. Old adults with frailty syndrome are prone to disabilities and hospitalization. Lifestyle is a context-based factor that has the potential to prevent frailty. Objectives This study aimed to assess the relationship between lifestyle and frailty among Iranian community-dwelling older adults. Design Setting This is a descriptive-analytical cross-sectional study. The participants were 513 older adults over 60 years by the convenience sampling method from the retirement center. Measurements Data were collected using Tilberg's frailty index, the Iranian elderly lifestyle questionnaire, and the Mini-Cog test. Data were analyzed with SPSS v.26 software by chi-square and logistic regression tests. Results The age of the participants was 66.43 ± 4.69 years. The male-to-female sex ratio was 1.5 (39.2% women). The lifestyle of 96 (19.3%) old adults was unfavorable. 18.7 percent of older adults had Frailty syndrome. The logistic regression test showed that moderate and favorable lifestyle (OR= 0.06; 95% CI: 0.02-0.16), age over 75 years (OR= 5.25; 95% CI: 2.35-11.69), retired employment status (OR= 0.13; 95% CI: 0.29-0.05) are factors that have a significant relationship with frailty (P< 0.05). Conclusion The findings showed that lifestyle can predict frailty. Therefore, it seems that an optimal lifestyle can prevent the frailty of older adults.
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Affiliation(s)
- S. Nazari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Bakhtiyary
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - A.N. Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - F. Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - P.F. Afshar
- Department of Gerontology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Pradana AA, Chiu HL, Lin CJ, Lee SC. Prevalence of frailty in Indonesia: a systematic review and meta-analysis. BMC Geriatr 2023; 23:778. [PMID: 38012546 PMCID: PMC10680226 DOI: 10.1186/s12877-023-04468-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Frailty increases the risks of hospitalization, injury, fall, psychological disorders, and death in older adults. Accurate estimation of the prevalence of frailty is crucial for promoting health in these individuals. Therefore, this study was conducted to estimate the prevalence of frailty and prefrailty in older adults residing in Indonesia. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, six electronic databases were searched (without any language restriction) for relevant articles from inception to February 2023. Studies on the prevalence of frailty and prefrailty in older adults (age ≥ 60 years) residing in Indonesia were included in the analysis. A random-effects model was selected a priori because of the expected high degree of heterogeneity in the study, followed by sensitivity analysis, subgroup analysis, and meta-regression. The protocol of this review study was registered in the PROSPERO database (CRD42022381132). RESULTS A total of 79 studies were identified, of which 20 were finally included in the analysis. The pooled prevalence of frailty and prefrailty in older adults in Indonesia was 26.8% and 55.5%, respectively. The pooled prevalence of frailty and prefrailty was 37.9% and 44.8% in nursing homes, 26.3% and 61.4% in hospitals, and 21.1% and 59.6% in community settings, respectively. Furthermore, the pooled prevalence of frailty and prefrailty was 21.6% and 64.3%, 18.7% and 62%, and 27.8% and 59.8% in studies using the Frailty Index-40, FRAIL, and Fried Frailty Phenotype questionnaires, respectively. However, the parameters did not vary significantly across measurement tools or study settings. Publication bias was not detected while the year of data collection influenced the heterogeneity between the studies. CONCLUSIONS To the best of our knowledge, this study is the first meta-analysis to report the prevalence of frailty and prefrailty in older adults residing in Indonesia. The gradual increase in the number of older adults with frailty or prefrailty in Indonesia is concerning. Therefore, the government, private sectors, health-care professionals, and the community must jointly design effective strategies and policies to address this problem.
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Affiliation(s)
- Anung Ahadi Pradana
- STIKes Mitra Keluarga, Bekasi-Indonesia, Indonesia
- International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Huei-Ling Chiu
- International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chen-Ju Lin
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Shu-Chun Lee
- International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Kristian YY, Cahyanur R, Wulandari Y, Sinaga W, Lukito W, Prasetyawaty F, Lestari W. Correlation between branched-chain amino acids intake and total lymphocyte count in head and neck cancer patients: a cross-sectional study. BMC Nutr 2023; 9:86. [PMID: 37452428 PMCID: PMC10347797 DOI: 10.1186/s40795-023-00746-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Cellular immunity as reflected by total lymphocyte count (TLC) has been proven to be related to overall survival rate cancer patients. Lymphocyte proliferation is regulated, to some extent, by nutritional factor. Branched chain amino acid (BCAA) is documented as one of numerous nutrients that play important role in lymphocyte proliferation through its effect on protein synthesis and DNA replication. Many studies describe the correlation between BCAA and TLC in hepatic cancer patients. This study emphasized the observation of that links in head and neck cancer patients. METHODS Eighty-five subjects were included in final analysis, aged 18-75, mostly male, with head and neck cancer who had not received treatment participated in this cross-sectional study at the Dr. Cipto Mangunkusumo General Hospital's radiation and medical haematology oncology clinic. The BCAAs intake was assessed using a semi-quantitative food frequency questionnaire. Flow cytometry method was used to quantify TLC. RESULTS Overall, the subjects' nutritional status mostly was considered normal, with the median intake of 1505 (800-3040) kcal/day of energy and mean of 73.96 ± 23.39 g/day of protein. Moreover, subjects' average BCAA intake was 10.92 ± 0.48 g/day. Meanwhile, 17.6% of subjects were found to have low TLC level. From thorough analysis, we did not find a strong correlation between BCAA level and TLC (r = 0.235, p = 0.056). CONCLUSION In participants with head and neck cancer who had not received chemoradiotherapy, there is no correlation between BCAA intake and TLC. The contribution of non-BCAA amino acids from dietary sources to lymphocyte proliferation requires further investigation. TRIAL REGISTRATION Retrospectively registered, with clinical trial number NCT05226065 on February 7th 2022.
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Affiliation(s)
- Yosua Yan Kristian
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
| | - Rahmat Cahyanur
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Yohannessa Wulandari
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wina Sinaga
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Widjaja Lukito
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Findy Prasetyawaty
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wiji Lestari
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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Takele MD, Sany K, Getie K, Wayessa DI, Jember G, Gobezie M, Abich Y, Kibret AK. Prevalence and associated factors of frailty among community dweller older adults living in Gondar town, northwest, Ethiopia: a community based cross-sectional study. BMC Public Health 2023; 23:1309. [PMID: 37420164 PMCID: PMC10329322 DOI: 10.1186/s12889-023-16201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Frailty is a multidimensional geriatric condition that increases vulnerability to stressors, increases the risk of negative health outcomes, and lowers quality of life in older people. However, little attention has been paid to frailty in developing countries, particularly in Ethiopia. Therefore, the aim of the study was to investigate the prevalence of frailty syndrome and the sociodemographic, lifestyle, and clinical factors associated with it. METHODS A community-based cross-sectional study design was conducted from April to June 2022. A total of 607 study participants were included using a single cluster sampling technique. The Tilburg frailty indicator, which is a self-reported schedule for assessment of frailty, required respondents to answer 'yes' or 'no' and the total attainable score ranged from 0 to 15. An individual with a score of ≥ 5 considered frail. Data were collected by interviewing the participants using a structured questionnaire, and the data collection tools were pre-tested before the actual data collection period to check for the accuracy of responses, language clarity, and appropriateness of the tools. Statistical analyses were performed using the binary logistic regression model. RESULTS More than half of the study participants were male, and the median age of the study participants was 70, with an age range of 60-95 years. The prevalence of frailty was 39% (CI 95%, 35.51-43.1). In the final multivariate analysis model, the following factors associated with frailty were obtained: older age (AOR = 6.26 CI (3.41-11.48), presence of two or more comorbidities (AOR = 6.05 CI (3.51-10.43), activity of daily life dependency (AOR = 4.12 CI (2.49-6.80), and depression (AOR = 2.68 CI (1.55-4.63) were found to be significant factors. CONCLUSION AND RECOMMENDATIONS Our study provides epidemiological characteristics and the risk factors of frailty in the study area. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially for older adults aged 80 and above years, and those with two or more comorbidities.
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Affiliation(s)
- Mihret Dejen Takele
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kedir Sany
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kefale Getie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Dechasa Imiru Wayessa
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Gashaw Jember
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Melese Gobezie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
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Qin Y, Hao X, Lv M, Zhao X, Wu S, Li K. A global perspective on risk factors for frailty in community-dwelling older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 105:104844. [PMID: 36335672 DOI: 10.1016/j.archger.2022.104844] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Frailty has become an important determinant of a series of adverse health outcomes. We explored the risk factors for frailty in older adults in the community from a global perspective and explore whether there are ethnic differences in these risk factors. METHODS The systematic review and meta-analysis (PROSPERO registration number: CRD42022323342) was searched using six electronic databases, including PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO (EBSCO) and CINAHL (EBSCO) from inception to October 2021. We assessed study eligibility by inclusion and excluded criteria. Cohort studies included were assessed according to the Newcastle-Ottawa Scale. Cross-sectional studies were assessed by the bias risk evaluation standard recommended by the Agency for Health care Research and Quality. The results were reported by a narrative synthesis and pooled analyses. Statistical analyses were performed in Review Manager 5.3 software. RESULTS We reviewed 10870 studies, and 62 studies were included. The results showed a significant association between multidomain risk factors and the frailty of global older adults, including demographic factors, health-related factors, and physical factors. Marital status, depression, risk of malnutrition, history of falls and disease-related symptoms are also risk factors for frailty among older people in Asia. CONCLUSION Multiple domain factors were associated with frailty among older people around the world. Compared with the rest of the world, Asian populations are exposed to more risk factors for frailty. Therefore, health care providers should consider the characteristics of risk factors for frailty in this region when formulating intervention measures related to frailty.
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Affiliation(s)
- Yuan Qin
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Xiaonan Hao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Miaohua Lv
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Xuetong Zhao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Shuang Wu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China
| | - Kun Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China.
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Kojima G, Taniguchi Y, Aoyama R, Tanabe M. Associations between loneliness and physical frailty in community-dwelling older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101705. [PMID: 35932978 DOI: 10.1016/j.arr.2022.101705] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/10/2022] [Accepted: 08/01/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Older adults may be at increased risk of loneliness. Frailty is also common in older adults, however, associations between loneliness and frailty have been understudied. This systematic review and meta-analysis aimed to explore evidence on how loneliness and frailty are correlated. METHODS A systematic search of the literature was conducted using 4 electronic databases in February 2022 for any studies published in 2000 or later that provided cross-sectional or longitudinal associations between loneliness and physical frailty in community-dwelling older adults. A meta-analysis was attempted to combine data when possible. RESULTS From 1386 studies identified by the initial search, 16 studies were included for this review. Standardized mean difference (SMD) meta-analysis based on mean loneliness score across 3 frailty groups provided by 6 cross-sectional studies showed that worse frailty status was significantly associated with a higher degree of loneliness (SMD between frail and robust, frail and prefrail, and prefrail and robust were 0.77 (95% confidence interval (CI)= 0.57-0.96), 0.37 (95%CI=0.25-0.50), and 0.30 (95%CI=0.20-0.40), respectively.) Meta-analyses combining cross-sectional data from 6 studies revealed that frailty was significantly associated with a higher risk of loneliness compared with robustness (3 studies: pooled OR=3.51, 95%CI=2.70-4.56 for frailty, pooled OR=1.88, 95%CI=1.57-2.25 for prefrailty) and compared with non-frailty (4 studies: pooled OR=2.05, 95%CI=1.76-2.39). A meta-analysis involving two longitudinal studies showed that baseline loneliness was associated with a significantly higher risk of worsening frailty (2 studies: pooled OR=1.41, 95%CI=1.16-1.72). CONCLUSIONS This systematic review and meta-analysis was the first, to our knowledge, to quantitatively demonstrate significant cross-sectional and longitudinal associations between loneliness and frailty in community-dwelling older adults.
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Affiliation(s)
- Gotaro Kojima
- Department of Research, Dr. AGA Clinic, Tokyo, Japan.
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Reijiro Aoyama
- Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Marianne Tanabe
- Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA
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Handajani YS, Schröder-Butterfill E, Hogervorst E, Turana Y, Hengky A. Depression among Older Adults in Indonesia: Prevalence, Role of Chronic Conditions and Other Associated Factors. Clin Pract Epidemiol Ment Health 2022; 18:e174501792207010. [PMID: 37274861 PMCID: PMC10156049 DOI: 10.2174/17450179-v18-e2207010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 06/07/2023]
Abstract
Background Depression is one of the most common illnesses worldwide, with a prevalence of 5.7% among older adults aged over 60. Depression is a severe health condition that can significantly affect the quality of life. Objective The objective of this study is to investigate the determinant factors of depression among older adults in Indonesia. Methods Data of 4236 adults of 60 years old and over were taken from the fifth wave of the Indonesian Family Life Survey (IFLS-5). Sociodemographic and multiple health-related variables collected through interviews and measurements were analyzed. Multivariate logistic regression was used to evaluate depression and its associated factors. Results The prevalence of depression assessed using ten questions from the Center for Epidemiologic Studies Depression Scale (CES-D 10) was 16.3%. Significant associated factors for depression were moderate and low subjective economic status, living in Java or other regions outside Sumatra and Java, no life satisfaction, self-perceived as having poor health, having dependency (IADL scores), and experienced falls and insomnia. Among chronic conditions, stroke, arthritis, and hearing impairment were also more common in depressed older adults. Conclusion Predictors of depression identified in this study may be used to help prevent and improve depression in Indonesian older adults, especially those who live on Java. Improvement in healthcare, especially in the prevention and rehabilitation of stroke, arthritis, possible frailty (falls and dependency), hearing impairment, and insomnia, concurrent with early detection of depression in these chronic conditions, may help create a better quality of life among Indonesian older adults.
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Affiliation(s)
- Yvonne Suzy Handajani
- School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Eef Hogervorst
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Yuda Turana
- School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Antoninus Hengky
- Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
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Yau PN, Foo CJE, Cheah NLJ, Tang KF, Lee SWH. The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis. Epidemiol Health 2022; 44:e2022058. [PMID: 35843601 PMCID: PMC9754909 DOI: 10.4178/epih.e2022058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region. METHODS A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis. RESULTS Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life. CONCLUSIONS Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.
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Affiliation(s)
- Phei Nie Yau
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | | | - Kar Foong Tang
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia,School of Pharmacy, Taylor’s University, Subang Jaya, Malaysia,Correspondence: Shaun Wen Huey Lee School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Malaysia E-mail:
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Prevalence of Frailty among Community-Dwelling Older Adults in Asian Countries: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10050895. [PMID: 35628034 PMCID: PMC9140771 DOI: 10.3390/healthcare10050895] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 12/14/2022] Open
Abstract
This study aimed to synthesize frailty prevalence among community-dwelling older adults in Asia and identify factors influencing prevalence estimates. Five electronic databases were searched by 29 April 2022, including representative samples of community-dwelling adults who were aged 60 years and older and lived in Asia. Cross-sectional or national longitudinal population-based cohort studies completed with validated instruments were selected. Twenty-one studies with 52,283 participants were included. The pooled prevalence rate of frailty was 20.5% (95% CI = 15.5% to 26.0%). The estimated frailty prevalence was 14.6% (95% CI = 10.9% to 18.8%) while assessed by the Fried frailty phenotype, 28.0% (95% CI = 21.3% to 35.3%) by the Cumulative Frailty Index, 36.4% (95% CI = 33.6% to 39.3%) by the Study of Osteoporotic Fractures (SOF) index, and 46.3% (95% CI = 40.1% to 52.4%) by the Clinical Frailty Scale (p < 0.01). Subgroup analysis in studies using the Fried’s phenotype tool found that frailty prevalence was increased with older age (p = 0.01) and was higher in those who were single (21.5%) than in married participants (9.0%) (p = 0.02). The study results supported a better understanding of frailty prevalence in different geographical distributions and provide references for health policy decision-making regarding preventing frailty progression in older adults.
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Idaiani S, Indrawati L. Functional status in relation to depression among elderly individuals in Indonesia: a cross-sectional analysis of the Indonesian National Health Survey 2018 among elderly individuals. BMC Public Health 2021; 21:2332. [PMID: 34969381 PMCID: PMC8719407 DOI: 10.1186/s12889-021-12260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Depression among elderly individuals is related to physical illness, functional status, prolonged treatment and other factors. Depression is not effectively treated with medication but can be alleviated by treating the physical illness and improving functional status. Therefore, this study aims to determine the relationship between functional status and depression in elderly individuals in Indonesia. METHODS The data used were obtained from a national survey dataset, namely, the Basic Health Research and Socio-Economic Survey in 2018, which was carried out in 34 provinces and 514 districts or cities. The total number of respondents was 93,829, aged ≥60 years. Functional status and depression were assessed using the Barthel index and MINI (Mini International Neuropsychiatric Interview), respectively. Furthermore, data processing was carried out with the Statistical Package for Social Sciences (SPSS) version 26 program and analyzed using the chi-square test and multiple logistic regression with the complex sample method. RESULTS Elderly individuals with severe dependence were at the greatest risk of becoming depressed compared to those without functional impairment or with independence after considering sociodemographic factors and disease history have 5.730 (95% CI = 4.302-7.632) the adj odds. Furthermore, this figure was higher than that of individuals with total dependence have 4.147 (95% CI = 3.231-5.231) the adj odds. The physical illness experienced also played a role in the risk for depression, which was higher among elderly individuals with stroke and a history of injury. The sociodemographic factors involved include low education and economic levels. In contrast, the area of residence and marital status had no statistically significant effect on the relationship between functional disorders and depression. CONCLUSIONS Elderly individuals with decreased functional status are prone to depression. The highest probability for depression was observed among those with severe dependence compared to those with total dependence. Consequently, interventions that involve various sectors, including social and family support, are needed.
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Affiliation(s)
- Sri Idaiani
- National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jalan Percetakan Negara. 29, Jakarta, 10560 Indonesia
| | - Lely Indrawati
- National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jalan Percetakan Negara. 29, Jakarta, 10560 Indonesia
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Vecchio A, Nakigozi G, Nakasujja N, Kisakye A, Batte J, Mayanja R, Anok A, Robertson K, Wawer MJ, Sacktor N, Rubin LH, Saylor D. Assessment, prevalence, and correlates of frailty among middle-aged adults with HIV in rural Uganda. J Neurovirol 2021; 27:487-492. [PMID: 33788138 DOI: 10.1007/s13365-021-00969-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/26/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
We investigated the prevalence and risk factors for frailty among people with HIV (PWH) in rural Uganda (n = 55, 47% male, mean age 44 years). Frailty was defined according to the Fried criteria with self-reported physical activity level replacing the Minnesota Leisure Time Activity Questionnaire. Alternate classifications for physical activity utilized were the sub-Saharan Africa Activity Questionnaire and the International Physical Activity Questionnaire. Eleven participants (19%) were frail. Frail participants were older (p < 0.001), less likely to be on antiretroviral therapy (p = 0.03), and had higher rates of depression (p < .001) and HIV-associated neurocognitive disorder (p = 0.003). Agreement between physical activity measures was sub-optimal. Prevalence of frailty was high among PWH in rural Uganda, but larger sample sizes and local normative data are needed.
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Affiliation(s)
- Alyssa Vecchio
- University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
| | | | | | | | - James Batte
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | - Aggrey Anok
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - Kevin Robertson
- University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Maria J Wawer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Ned Sacktor
- Johns Hopkins University School of Medicine, Baltimore, USA
| | - Leah H Rubin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Johns Hopkins University School of Medicine, Baltimore, USA
| | - Deanna Saylor
- Johns Hopkins University School of Medicine, Baltimore, USA
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Rahman MM, Hamiduzzaman M, Akter MS, Farhana Z, Hossain MK, Hasan MN, Islam MN. Frailty indexed classification of Bangladeshi older adults' physio-psychosocial health and associated risk factors- a cross-sectional survey study. BMC Geriatr 2021; 21:3. [PMID: 33402094 PMCID: PMC7786917 DOI: 10.1186/s12877-020-01970-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 12/16/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Frailty is associated with healthy ageing, and it has been identified as a means of measuring older adults' physio-psychosocial health. We know about the ageing trends and common diseases of older adults living in South Asia, but literature to date does not widely feature their health status based on frailty, especially in Bangladesh. This study aims to understand the prevalence of frailty in Bangladeshi older adults; classify their health status; and investigate associated risk factors. METHODS A cross-sectional study was conducted in the north-eastern region (i.e. Sylhet City Corporation) of Bangladesh. Four hundred participants aged 55 years and above were randomly selected, attended a health assessment session and completed a multi-indicator survey questionnaire. We developed a 30-indicator Frailty Index (FI30) to assess the participant's health status and categorized: good health (no-frailty/Fit); slightly poor health (mild frailty); poor health (moderate frailty); and very poor health (severe frailty). Pearson chi-square test and binary logistic regression analysis were conducted. RESULTS The participants' mean age was 63.6 years, and 61.6% of them were assessed in poor to very poor health (moderate frailty/36.3% - severe frailty/25.3%). The eldest, female and participants from lower family income were found more frailty than their counterparts. Participants aged 70 years and above were more likely (adjusted OR: 4.23, 95% CI: 2.26-7.92, p < 0.0001) to experience frailty (medical conditions) than the pre-elderly age group (55-59 years). Female participants were more vulnerable (adjusted OR = 1.487, 95% CI: 0.84-2.64, p < 0.0174) to frailty (medical conditions) than male. Also, older adults who had higher family income (Income>$473.3) found a lower risk (adjusted OR: 0.294, 95% CI: 0.11-0.76, p < 0.011) of frailty (poor health). CONCLUSION Our study results confirm the prevalence of frailty-related disorders in Bangladeshi older adults and highlight the importance of targeted clinical and community-led preventive care programs.
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Affiliation(s)
- Mohammad Meshbahur Rahman
- Biomedical Research Foundation, Dhaka, 1230, Bangladesh.
- Basic Science Division, World University of Bangladesh, Dhaka, 1230, Bangladesh.
| | - Mohammad Hamiduzzaman
- Flinders University Rural Health SA, College of Medicine & Public Health, Flinders University, Bedford, South Australia, Australia
| | | | - Zaki Farhana
- Bangladesh Bank-The Central Bank of Bangladesh, Dhaka, 1215, Bangladesh
| | - Mohammad Kamal Hossain
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Mohammad Nayeem Hasan
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Md Nazrul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
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Widagdo TM, Rianto N, Restyandito, Kurniawan E. Correlates of visuospatial ability among older people in Indonesia. Indian J Community Med 2021; 46:614-617. [PMID: 35068720 PMCID: PMC8729291 DOI: 10.4103/ijcm.ijcm_526_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/03/2021] [Indexed: 11/07/2022] Open
Abstract
Introduction: The Indonesian elderly population keeps increasing. Aging is related with degeneration process, one of which is a decrease in cognitive function, including visuospatial ability. This is the first study on the visuospatial ability of Indonesian older people. Objective: This research aimed to assess the visuospatial ability and its correlation with sex, age, education, and general cognitive function among older people in Indonesia. Subjects and Methods: The research subjects were older people aged ≥60 years with Mini-Mental State Examination (MMSE) score ≥24. The visuospatial ability was assessed using Wechsler Adult Intelligence Scale-Revised (WAIS-R) Block Design Test (BDT). Regression analysis was performed to reveal the correlation of sex, age, education, and global cognitive function with visuospatial ability. Results: Sixty older people participated in this research, with an average age of 68.08 ± 6.24, mean MMSE score of 27.43 ± 1.71, and mean WAIS-R BDT score of 27.8 ± 7.27. The female and older individuals tended to have lower scores. Subjects with higher education and global cognitive function had higher WAIS-R BDT scores. Regression analysis showed that age and sex did not have significant effect, but education and global cognitive function had positive effect on visuospatial ability. Conclusion: There is a significant correlation between education and global cognitive function with visuospatial ability among older people in Indonesia.
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Hui BY, Khorgami Z, Puthoff JS, Kuwada TS, Lim RB, Chow GS. Postoperative sepsis after primary bariatric surgery: an analysis of MBSAQIP. Surg Obes Relat Dis 2020; 17:667-672. [PMID: 33509730 DOI: 10.1016/j.soard.2020.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/02/2020] [Accepted: 12/06/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Identifying patients at higher risk of postoperative sepsis (PS) may help to prevent this life-threatening complication. OBJECTIVES This study aimed to identify the rate and predictors of PS after primary bariatric surgery. SETTING An analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) 2015-2017. METHODS Patients undergoing elective sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) were included. Exclusion criteria were revisional, endoscopic, and uncommon, or investigational procedures. Patients were stratified by the presence or absence of organ/space surgical site infection (OS-SSI), and patients who developed sepsis were compared with patients who did not develop sepsis in each cohort. Logistic regression was used to identify independent predictors of PS. RESULTS In total, 438,752 patients were included (79.4% female, mean age 44.6±12 years). Of those, 661 patients (.2%) developed PS of which 245 (37.1%) developed septic shock. Out of 892 patients with organ/space surgical site infections (OS-SSI), 298 (45.1%) developed sepsis (P <.001). Patients who developed PS had higher mortality (8.8% versus .1%, P < .001), and this was highest in patients without OS-SSI (11.8% versus 5%, P = .002). The main infectious complications associated with PS in patients without OS-SSI were pneumonia and urinary tract infection. Independent predictors of PS in OS-SSI included RYGB versus SG (OR, 1.8), and age ≥50 years (OR, 1.4). Independent predictors of PS in patients without OS-SSI were conversion to other approaches (OR, 6), operation length >2 hours (OR, 5.7), preoperative dialysis (OR, 4.1), preoperative therapeutic anticoagulation (OR, 2.8), limited ambulation most or all of the time (OR, 2.4), preoperative venous stasis (OR, 2.4), previous nonbariatric foregut surgery (OR, 2), RYGB versus SG (OR, 2), hypertension on medication (OR, 1.5), body mass index ≥50 kg/m2(OR, 1.4), age ≥50 years (OR, 1.3), obstructive sleep apnea (OR, 1.3). CONCLUSION Development of OS-SSI after primary bariatric surgery is associated with sepsis and increased 30-day mortality. Patients without OS-SSI who develop PS have a significantly higher mortality rate compared with patients with OS-SSI who develop PS. Early identification and intervention in patients with PS, including those without OS-SSI, may improve survival in this high-risk group.
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Affiliation(s)
- Benedict Y Hui
- Atrium Health Weight Management, Section of Bariatric and Metabolic Surgery, Department of Surgery, Atrium Health, Charlotte, North Carolina
| | - Zhamak Khorgami
- Department of Surgery, School of Community Medicine, University of Oklahoma, Tulsa, Oklahoma; Harold Hamm Diabetes Center, University of Oklahoma, Oklahoma City, Oklahoma.
| | - Justin S Puthoff
- Department of Surgery, School of Community Medicine, University of Oklahoma, Tulsa, Oklahoma
| | - Timothy S Kuwada
- Atrium Health Weight Management, Section of Bariatric and Metabolic Surgery, Department of Surgery, Atrium Health, Charlotte, North Carolina
| | - Robert B Lim
- Department of Surgery, School of Community Medicine, University of Oklahoma, Tulsa, Oklahoma
| | - Geoffrey S Chow
- Department of Surgery, School of Community Medicine, University of Oklahoma, Tulsa, Oklahoma
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Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186549. [PMID: 32916809 PMCID: PMC7557756 DOI: 10.3390/ijerph17186549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/02/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022]
Abstract
Frailty is a multidimensional syndrome, which is a worldwide concern within the field of geriatrics due to the aggravating effect on the physical and mental functions of the elderly. This study aimed to determine the prevalence and risk factors of the frailty syndrome among urban-living community-dwelling elderly in Malaysia. A cross-sectional study was conducted among 301 community-dwelling elders. Frailty status was assessed using the Fried phenotype criteria. Depressive symptoms were assessed using the Geriatric Depression Scale (M-GDS-14), whereas the functional abilities and cognitive status were measured using the Lawton Instrumental Activities of Daily Living (Lawton IADL) scale and the Mini-Mental State Examination (MMSE-M), respectively. Malnutrition risk was observed through the abridged version (Short Form) of the Mini Nutritional Assessment (MNA-SF). Multinomial logistic regression analysis was employed to determine the significant predictors of the frailty syndrome. Three hundred and one elderly persons engaged in this study, with a mean age of 67.08 ± 5.536 ranging between 60 to 84 years old. The prevalence values of frailty and pre-frail were 15.9% and 72.8%, respectively, in which women appeared to be at a higher risk of frailty. The multivariate model revealed that frailty could be predicted from an increase in age, lower household income, being at risk of malnutrition, wasting (low skeletal muscle mass), and high serum C-reactive protein (CRP) level. A holistic approach is suggested for managing the frailty syndrome as it involves a decline in the multiple components of the geriatric syndrome.
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